Efficacy of Levothyroxine on the Frequency and Severity of Migraine in Children with Subclinical Hypothyroidism

Abstract

Introduction: Migraine is the most frequent primary intermittent headache in children. Hypothyroidism can exacerbate primary headaches and be a risk factor for persistent headache. Subclinical hypothyroidism is diagnosed when the level of TSH is high and the plasma concentration of free T4 is normal. Objective: To evaluate the efficacy of levothyroxine in the frequency and severity of migraine in children with subclinical hypothyroidism. Materials and methods:Prospective, observational and analytical study. Pediatric patients with a diagnosis of migraine and subclinical hypothyroidism (TSH >4.5 mU/L and normal concentration of free T4). Exclusion criteria: Hemiplegic migraine, basilar, retinal migraine, periodic childhood syndromes, epilepsy, asthma, diabetes mellitus, nephropathy, liver disease, previously diagnosed thyroid disease. Evaluation (for six months) of the frequency (monthly) and severity (severity score) of migraine in children with subclinical hypothyroidism treated with levothyroxine, during three months. Results: Patients attended: 31; excluded: 14; studied: 17 (9 girls). Age: 11.2 + - 1.89 years. The monthly frequency of migraine before treatment with levothyroxine was 14.75 + - 4.1 and after therapy, 5.39 + - 2.1 (p = 0.001); migraine severity score before treatment was 7.2 + - 1.2 and after therapy, 4.05 + - 1.31 (p = 0.001). Conclusions:Levothyroxine therapy in children with migraine and subclinical hypothyroidism was effective in decreasing the frequency and intensity of migraine in patients.